强迫症抑制控制缺陷及其自然心理疗法干预
文献类型：学位论文
| 作者 | 朱蓉蓉 |
| 答辩日期 | 2024-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 张向阳 ; 王冬梅 |
| 关键词 | 强迫症 抑制控制 认知抑制 行为抑制 自然心理疗法 |
| 学位名称 | 理学博士 |
| 学位专业 | 认知神经科学 |
| 其他题名 | Inhibitory control deficits and Natural Psychotherapy intervention in patients with Obsessive-compulsive Disorder |
| 中文摘要 | Obsessive-compulsive disorder (OCD) is a complex and prevalent mental disorder that significantly impacts the social functioning of patients. OCD is characterized by obsessive thoughts or compulsive behaviors or both. Obsessive thoughts are intrusive, unwanted, repetitive, and persistent thoughts, images, and impulses; Compulsions are are repetitive, stereotyped actions that the individual finds difficult to control. Although people with OCD understand the insignificance of repeated intrusive thoughts and the ineffectiveness of ritualized behaviors, they are unable to suppress them. Currently, there is a lack of highly effective treatments and interventions for OCD. The quality of inhibitory control can comprehensively reflect cognitive status and plays a crucial role in the physical and mental development of individuals. The core symptoms of OCD strongly suggest inhibitory failure. This study conducts four investigations on OCD from the perspective of inhibitory control. Study 1 investigates whether there are impairments in general cognitive inhibition and behavioral inhibition in OCD. Experiment 1 used the traditional Stroop task to explore cognitive inhibition in patients with OCD. The results indicated that patients with OCD exhibit difficulties in cognitive inhibition, as evidenced by longer reaction times to complete the tasks compared to the control group, despite having similar accuracy rates. Furthermore, there was a negative correlation between the total scores of OCD symptoms and cognitive inhibition ability, specifically obsessive thoughts. Double-choice oddball paradigm was used to investigate behavioral inhibition in OCD patients, and the results showed that OCD patients had no behavioral inhibition difficulties compared with healthy controls. Additionally, it was found that general behavioral inhibition ability in OCD is related to obsessive thoughts rather than compulsive behaviors. The current findings contribute to our understanding of general cognitive inhibition and behavioral inhibition in Chinese OCD patients and suggest that cognitive and behavioral inhibition should be studied separately in the OCD patients. In Study 2, two experiments were conducted to explore the event-related potential (ERP) of cognitive inhibition and behavioral inhibition in OCD under threat cues and neutral cues, using Stroop task and SST task, respectively. Experiment 3 found that OCD patients had cognitive inhibition difficulties. The amplitude of N450 was enhanced in patients with OCD compared to healthy controls. and the amplitude of the conflict SP was reduced in patients with OCD compared to healthy controls in the incongruent condition. In the emotional Stroop task, the threat situation could enhance the N2 amplitude and N450 amplitude and reduce the conflict SP amplitude. Experiment 4 found that OCD did not have difficulty in behavioral inhibition under emotional cues, and the threat situation did not affect the performance of behavioral inhibition in OCD, but there was a decrease in N2 amplitude and an increase in P3 amplitude under threat conditions in the emotional SST task. In Study 3, an innovative localized natural psychotherapy intervention for inhibitory control in OCD, is the first study to use a psychological intervention for inhibitory control under emotional cues in patients with OCD. In experiment 5, we found that natural psychotherapy improved cognitive inhibition in OCD patients and improved abnormal SP amplitude under threat cues; There was no significant improvement in behavioral inhibition of OCD before and after natural psychotherapy intervention, but it reduced N2 amplitude under threat cues. Study 4 found that OCD had abnormal functional connectivity of brain regions related to behavioral inhibition through resting-state functional magnetic resonance imaging(fMRI), which was specifically manifested as decreased functional connectivity between Right anterior insula, Right thalamus and midbrain. After naturopathic intervention, the functional connectivity between right thalamusmidbrain was significantly enhanced, and the strength of functional connectivity between these two related brain regions could predict the improvement of behavioral inhibition under threat cues. In this study, we explored whether inhibitory control difficulties exist in OCD from the aspects of cognitive inhibition and behavioral inhibition. In this study, four studies and six experiments were conducted to address the "what", "why" and "how" questions of inhibitory control in OCD by integrating electrophysiological and resting-state fMRI techniques. By examining the behavioral performance and ERP of cognitive inhibition and behavioral inhibition in OCD under general and emotional cues, the separation of cognitive inhibition and behavioral inhibition in OCD was found, which deepened the understanding of inhibitory control in OCD and verified previous theoretical models. It has promoted the basic development of this field and provided a theoretical basis for carrying out inhibitory control intervention in OCD. In addition, our study also creatively used a local Chinese culture-based natural psychotherapy to intervene in inhibition control of OCD. Our study found that natural psychotherapy could effectively deal with cognitive inhibition in OCD and improve abnormal ERP activity related to threat cues, providing a new practical method for the clinical intervention of OCD. |
| 英文摘要 | 强迫症是一种复杂且常见的精神障碍，影响患者的社会功能。强迫症的特征是强迫思维或强迫行为或两种症状同时存在。强迫思维是指那些侵入性的、不需要的、重复的、持续的想法、图像和冲动；强迫行为是指反复出现无法停止的刻板行为。尽管强迫症患者理解反复闯入的侵入性想法无意义和仪式化行为无效，但是无法抑制。对于强迫症，目前缺乏有效的治疗和干预方法。 抑制控制能力的好坏能够比较全面地展示认知状态，在个体身心发展中发 挥重要作用。强迫症的核心症状强烈提示抑制性失败。本研究从抑制控制的角度在强迫症中展开四个研究。 研究一探索强迫症是否存在一般认知抑制和行为抑制上的损伤。实验 1 采 用经典 Stroop 任务范式在强迫症人群中探索了强迫症患者的认知抑制，结果表明强迫症患者存在认知抑制困难，表现在和对照组相比具有同样正确率的条件下，完成任务的反应时更长，且强迫症患者的强迫症状总分和强迫思维和认知抑制能力呈负相关。实验 2 采用双选择 oddball 范式在强迫症人群中探索了强迫症患者的行为抑制，结果表明强迫症患者和健康对照组相比，未存在行为抑制困难问题。并且发现，强迫症的一般行为抑制能力和强迫思维有关，而不是强 迫行为。当前的研究结果有助于我们对中国人群的强迫症患者的一般认知抑制和行为抑制的认识，提示我们应该在强迫症中把认知抑制和行为抑制分开研究。 研究一探索强迫症是否存在一般认知抑制和行为抑制上的损伤。实验 1 采 用经典 Stroop 任务范式在强迫症人群中探索了强迫症患者的认知抑制，结果表明强迫症患者存在认知抑制困难，表现在和对照组相比具有同样正确率的条件下，完成任务的反应时更长，且强迫症患者的强迫症状总分和强迫思维和认知抑制能力呈负相关。实验 2 采用双选择 oddball 范式在强迫症人群中探索了强迫症患者的行为抑制，结果表明强迫症患者和健康对照组相比，未存在行为抑制困难问题。并且发现，强迫症的一般行为抑制能力和强迫思维有关，而不是强迫行为。当前的研究结果有助于我们对中国人群的强迫症患者的一般认知抑制 和行为抑制的认识，提示我们应该在强迫症中把认知抑制和行为抑制分开研究。 研究三通过具有中国传统文化特色的自然心理疗法干预强迫症的抑制控制。通过实验 5 我们发现，自然心理疗法能够改善强迫症的强迫症状，改善强迫症患者的认知抑制，也改善威胁情景 Stroop 任务下异常的 SP 的波幅，并且干预前后强迫症状的变化和威胁线索下认知抑制能力的变化正相关；自然心理疗法 治疗前后强迫症的行为抑制没有明显改善，但降低了威胁情境下的 N2 波幅。 研究四通过静息态 fMRI 发现，强迫症存在和行为抑制有关的脑区功能连接的异常，具体表现为右前岛叶(Right anterior insula)、右丘脑(Right thalamus) 和中脑(midbrain)之间的功能连接的降低；并在自然心理疗法对强迫症干预后，右丘脑-中脑的功能连接得到了显著的增强，并且这两个相关脑区的功能连接强 度能够预测威胁情境下的行为抑制能力的改善。 本研究从认知抑制和行为抑制两个方面来探究强迫症中是否存在抑制控制 困难的问题。通过四个研究六个实验综合采用 ERP 和静息态 fMRI 技术试图回 答强迫症中的抑制控制“怎么了”、“为什么”和“如何做”这三个问题。通过 考察一般线索和情绪线索下的强迫症的认知抑制和行为抑制的行为表现和神经 电生理活动，发现了强迫症在认知抑制和行为抑制上的分离，这一研究结果加 深了对强迫症的抑制控制的认识和理解，验证了以往的理论模型，推动了该领 域基础的发展以及为在强迫症中开展抑制控制干预提供一定的理论依据。此外， 我们的研究还创新性的采用基于中国传统文化下的自然心理疗法对强迫症的抑 制控制进行干预，研究发现自然心理疗法能够有效地干预强迫症中的认知抑制，并且改善与威胁情境相关的异常脑电活动，为强迫症的临床干预提供了一种新的实践方法。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48125]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 朱蓉蓉. 强迫症抑制控制缺陷及其自然心理疗法干预[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
浏览0
下载0
收藏0
其他版本
除非特别说明，本系统中所有内容都受版权保护，并保留所有权利。